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3 Percent of Youth Testing Positive for COVID-19 in ED Have Severe Outcomes

FRIDAY, Jan. 14, 2022 -- Approximately 3 percent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive youth tested in emergency departments experience severe outcomes within two weeks of their index visit, according to a study published online Jan. 11 in JAMA Network Open.

Anna L. Funk, Ph.D., from the University of Calgary in Alberta, Canada, and colleagues estimated the proportion of children with severe COVID-19 outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (March 2020 to June 2021). The analysis included 3,222 youth seen in 41 emergency departments across 10 countries.

The researchers found that after 14 days of follow-up, 22.8 percent of children were hospitalized, 3.3 percent of whom had severe outcomes, and four children died (0.12 percent). Severe outcomes were associated with being aged 5 to 18 years (age 5 to <10 years versus <1 year: odds ratio [OR], 1.60; age 10 to <18 years versus <1 year: OR, 2.39) and having a self-reported chronic illness (OR, 2.34), a prior episode of pneumonia (OR, 3.15), and symptoms starting four to seven days prior to seeking emergency care (versus starting three or fewer days before seeking care: OR, 2.22). In a subgroup of 2,510 children discharged home from the emergency department who had complete follow-up, 2 percent were eventually hospitalized and 0.5 percent had severe outcomes.

"The findings of this study suggest that risk factors such as age, underlying chronic illness, and symptom duration may be useful for clinicians to consider when evaluating pediatric patients with SARS-CoV-2 infection," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text

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